Individual provider Active NPI

Wilfred Anyam Mbah

  • Home Health Aide
  • New Carrollton, MD
National Provider Identifier
1013769850
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA200003700 Issued in DC
Practice address
6903 Good Luck Rd
New Carrollton, MD 20784-3620
Phone
(240) 854-1073
NPI assigned
Apr 4, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA200003700 DC Primary

Addresses

Primary practice location

6903 Good Luck Rd
New Carrollton, MD 20784-3620

Mailing address

6903 Good Luck Rd
New Carrollton, MD 20784-3620
Phone (240) 854-1073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HHA200003700DCMDHome Health Aide

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1013769850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6903 GOOD LUCK RD",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207843620",
            "telephone_number": "240-854-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6903 GOOD LUCK RD",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207843620",
            "telephone_number": "240-854-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBAH",
        "first_name": "WILFRED",
        "middle_name": "ANYAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA200003700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Carrollton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.